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Individual

DR. MICHAEL ALAN MANBECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
(574) 251-2861
Mailing address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
(574) 251-2861

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01044874A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000084423
BCBS
IN
01
100012683
RAILROAD MEDICARE
IN
05
200077210A
IN
01
5314205
AETNA
IN
01
8086388003
CIGNA
IN
Enumeration date
06/02/2005
Last updated
01/21/2011
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